Michael Chua, Priyank Yadav, Adam Bobrowski, Jin Kyu Kim, Jan Michael Silangcruz, Jessica Ming, Mandy Rickard, Armando Lorenzo, Darius Bagli, Antoine Khoury
{"title":"背侧缩短术与腹侧延长术治疗尿道下裂患者/无严重尿道下裂患者的先天性腹侧弯曲 一项比较研究的荟萃分析。","authors":"Michael Chua, Priyank Yadav, Adam Bobrowski, Jin Kyu Kim, Jan Michael Silangcruz, Jessica Ming, Mandy Rickard, Armando Lorenzo, Darius Bagli, Antoine Khoury","doi":"10.5489/cuaj.8223","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Herein, we compared surgical outcome of dorsal shortening (DS) vs. ventral lengthening (VL) for correcting congenital ventral curvatures.</p><p><strong>Methods: </strong>A systematic literature search was performed in September 2021 using the PubMed, EMBASE, Scopus, CENTRAL, ProQuest, and Clinicaltrials.gov databases. Comparative studies were identified and evaluated according to Cochrane Collaboration recommendations. Assessed outcomes included success and complication rates, which were extrapolated for the respective odds ratios (OR) with 95% confidence intervals (CIs). Subgroup analyses were performed according to congenital curvature, with or without severe hypospadias or recurrent curvatures (PROSPERO: CRD42021276193).</p><p><strong>Results: </strong>Based on pooled effect estimates from 12 studies with 430 (DS 253, VL 177) cases of ventral curvature repair, VL rendered a better success rate for curvature correction (OR 4.20, 95% CI 2.11, 8.33) than DS, with comparable composite surgical complication rates (OR 0.77, 95% CI 0.27, 2.18). Subgroup analysis showed that the success rate remained significantly better for VL among patients with associated severe hypospadias (OR 3.59, 95% CI 1.25, 10.26) and recurrent penile curvatures (OR 5.70, 95% CI 1.69, 19.21) but not among those with congenital curvature without hypospadias or those with mild hypospadias (OR 2.99, 95% CI 0.32, 27.57).</p><p><strong>Conclusions: </strong>For congenital curvature associated with severe hypospadias and recurrent curvatures, VL renders a modestly better success rate; however, careful selection of patients is key for best outcome.</p>","PeriodicalId":9574,"journal":{"name":"Canadian Urological Association journal = Journal de l'Association des urologues du Canada","volume":"17 7","pages":"E208-E214"},"PeriodicalIF":0.0000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382216/pdf/cuaj-7-208.pdf","citationCount":"0","resultStr":"{\"title\":\"Dorsal shortening vs. ventral lengthening for congenital ventral curvature in patients with/without severe hypospadias A meta-analysis of comparative studies.\",\"authors\":\"Michael Chua, Priyank Yadav, Adam Bobrowski, Jin Kyu Kim, Jan Michael Silangcruz, Jessica Ming, Mandy Rickard, Armando Lorenzo, Darius Bagli, Antoine Khoury\",\"doi\":\"10.5489/cuaj.8223\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Herein, we compared surgical outcome of dorsal shortening (DS) vs. ventral lengthening (VL) for correcting congenital ventral curvatures.</p><p><strong>Methods: </strong>A systematic literature search was performed in September 2021 using the PubMed, EMBASE, Scopus, CENTRAL, ProQuest, and Clinicaltrials.gov databases. Comparative studies were identified and evaluated according to Cochrane Collaboration recommendations. Assessed outcomes included success and complication rates, which were extrapolated for the respective odds ratios (OR) with 95% confidence intervals (CIs). Subgroup analyses were performed according to congenital curvature, with or without severe hypospadias or recurrent curvatures (PROSPERO: CRD42021276193).</p><p><strong>Results: </strong>Based on pooled effect estimates from 12 studies with 430 (DS 253, VL 177) cases of ventral curvature repair, VL rendered a better success rate for curvature correction (OR 4.20, 95% CI 2.11, 8.33) than DS, with comparable composite surgical complication rates (OR 0.77, 95% CI 0.27, 2.18). Subgroup analysis showed that the success rate remained significantly better for VL among patients with associated severe hypospadias (OR 3.59, 95% CI 1.25, 10.26) and recurrent penile curvatures (OR 5.70, 95% CI 1.69, 19.21) but not among those with congenital curvature without hypospadias or those with mild hypospadias (OR 2.99, 95% CI 0.32, 27.57).</p><p><strong>Conclusions: </strong>For congenital curvature associated with severe hypospadias and recurrent curvatures, VL renders a modestly better success rate; however, careful selection of patients is key for best outcome.</p>\",\"PeriodicalId\":9574,\"journal\":{\"name\":\"Canadian Urological Association journal = Journal de l'Association des urologues du Canada\",\"volume\":\"17 7\",\"pages\":\"E208-E214\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382216/pdf/cuaj-7-208.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Canadian Urological Association journal = Journal de l'Association des urologues du Canada\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5489/cuaj.8223\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian Urological Association journal = Journal de l'Association des urologues du Canada","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5489/cuaj.8223","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
简介:在此,我们比较了背侧缩短术(DS)与腹侧延长术(VL)矫正先天性腹弯的手术效果:在此,我们比较了背侧缩短术(DS)与腹侧延长术(VL)矫正先天性腹弯的手术效果:方法:2021 年 9 月,我们使用 PubMed、EMBASE、Scopus、CENTRAL、ProQuest 和 Clinicaltrials.gov 数据库进行了系统的文献检索。根据 Cochrane 协作组织的建议,确定并评估了对比研究。评估结果包括成功率和并发症发生率,并推断出各自的几率比(OR)和 95% 的置信区间(CI)。根据先天性尿道弯曲、有无严重尿道下裂或复发性尿道弯曲进行了分组分析(PROSPERO:CRD42021276193):根据 12 项研究对 430 例(DS 253 例,VL 177 例)腹侧弯曲修复的汇总效果估计,VL 的弯曲矫正成功率(OR 4.20,95% CI 2.11,8.33)高于 DS,手术并发症综合发生率(OR 0.77,95% CI 0.27,2.18)与 DS 相当。亚组分析显示,在伴有重度尿道下裂(OR 3.59,95% CI 1.25,10.26)和复发性阴茎弯曲(OR 5.70,95% CI 1.69,19.21)的患者中,VL的成功率仍明显高于DS(OR 2.99,95% CI 0.32,27.57):结论:对于伴有严重尿道下裂和复发性尿道下裂的先天性尿道弯曲患者,VL 的成功率略高,但仔细选择患者是获得最佳疗效的关键。
Dorsal shortening vs. ventral lengthening for congenital ventral curvature in patients with/without severe hypospadias A meta-analysis of comparative studies.
Introduction: Herein, we compared surgical outcome of dorsal shortening (DS) vs. ventral lengthening (VL) for correcting congenital ventral curvatures.
Methods: A systematic literature search was performed in September 2021 using the PubMed, EMBASE, Scopus, CENTRAL, ProQuest, and Clinicaltrials.gov databases. Comparative studies were identified and evaluated according to Cochrane Collaboration recommendations. Assessed outcomes included success and complication rates, which were extrapolated for the respective odds ratios (OR) with 95% confidence intervals (CIs). Subgroup analyses were performed according to congenital curvature, with or without severe hypospadias or recurrent curvatures (PROSPERO: CRD42021276193).
Results: Based on pooled effect estimates from 12 studies with 430 (DS 253, VL 177) cases of ventral curvature repair, VL rendered a better success rate for curvature correction (OR 4.20, 95% CI 2.11, 8.33) than DS, with comparable composite surgical complication rates (OR 0.77, 95% CI 0.27, 2.18). Subgroup analysis showed that the success rate remained significantly better for VL among patients with associated severe hypospadias (OR 3.59, 95% CI 1.25, 10.26) and recurrent penile curvatures (OR 5.70, 95% CI 1.69, 19.21) but not among those with congenital curvature without hypospadias or those with mild hypospadias (OR 2.99, 95% CI 0.32, 27.57).
Conclusions: For congenital curvature associated with severe hypospadias and recurrent curvatures, VL renders a modestly better success rate; however, careful selection of patients is key for best outcome.